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Obstructive sleep apnea syndrome (OSAS) remains widely underdiagnosed, despite its well-established cardiovascular and cognitive consequences. Although continuous positive airway pressure (CPAP) remains the first-line treatment for severe OSAS and for moderate OSAS associated with comorbidities, adherence often remains suboptimal. Custom-made mandibular advancement devices (MAD) therefore represent an attractive therapeutic alternative for patients with symptomatic mild to moderate OSAS. Generally better tolerated than CPAP, they are associated with better adherence. This article guides clinicians through the different stages of patient management with MAD : indication, fabrication and treatment follow-up.